2
www.ias2013.org Kuala Lumpur, Malaysia, 30 June - 3 July 2013 In the USA, young men who have sex with men (YMSM), especially those who are ethnic minorities, have high prevalence and incidence of HIV Many report inconsistent condom use for receptive anal intercourse (RAI) Rectal microbicides (RM) could be an alternative if if efficacious and consistently used (adherence)

3
www.ias2013.org Kuala Lumpur, Malaysia, 30 June - 3 July 2013 “How frequently would YMSM with a history of condomless RAI apply a gel prior to RAI in their everyday lives?”

5
www.ias2013.org Kuala Lumpur, Malaysia, 30 June - 3 July 2013 Interactive Voice Response System (IVRS) to report RAI and gel use weekly Used and unused applicators returned to clinic at 6 and 12 weeks Web-based CASI completed at the end of 12 weeks with questions on gel use with RAI

12
www.ias2013.org Kuala Lumpur, Malaysia, 30 June - 3 July 2013 N(%) I did not have the gel with me34 (85%) I forgot19 (48%) I did not want to use the gel 5 (13%) My sexual partner did not want me to use the gel 4 (10%) The gel was messy 4 (10%) I did not like how the gel felt inside me 2 ( 5%)

13
www.ias2013.org Kuala Lumpur, Malaysia, 30 June - 3 July 2013 Not having gel on hand “I forgot the stuff at home, and I had sex, like it was an unexpected one. That’s why I couldn’t use it.” “I was just waking up and the gel was in another room and my partner wanted to have sex right away.”

14
www.ias2013.org Kuala Lumpur, Malaysia, 30 June - 3 July 2013 Forgetting “I had the gel with me in the same room, I was ready to use it and we got into foreplay, and by the time we were having anal sex I forgot about the gel.”

15
www.ias2013.org Kuala Lumpur, Malaysia, 30 June - 3 July 2013 Problems with discreet usage/not wanting to use gel “Some of the time I didn’t want to tell someone that I had to use it, and I wasn’t able to discreetly use it.” “[The partner] was from online, but I didn’t just feel comfortable using that with him. I just thought it would be weird to just whip that out.”

16
www.ias2013.org Kuala Lumpur, Malaysia, 30 June - 3 July 2013 Applicator portability/not having gel on hand “It was not something planned. So, the gel was not on hand…I’m not going to put that syringe in my pocket just in case something happens.”